BACKGROUND

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Uganda has registered declining HIV rates since 1992 especially among the youth.

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NGO,S have offered VCT services without special consideration of the peculiar needs of youth.

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HIV rates have remained higher among young females than males.

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Out of school youths are particularly a hard group to reach.

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HIV/AIDS SITUATION AMONG YOUNG PEOPLE

 Young people are at the centre of the HIV/AIDS epidemic  Young people are particularly susceptible to HIV infection   They also carry the burden of caring for family members living with HIV/AIDS AIDS is shattering young people’s opportunities for healthy adult lives  It is the young people who offer the greatest hope for changing the course of the epidemic 3

UGANDA’S NATIONAL AIDS POLICY

 Vision: To have a healthy, AIDS free, socially responsible and economically productive population.

 Mission: To create an environment in which the national response to HIV/AIDS is coherent, systematic and effective.

 Goal: The policy goal is to minimize the prevalence of HIV/AIDS and eliminate it’s social – economic impact 4

PRINCIPLES AND CORE VALUES

 There will be continued openness about HIV/AIDS  HIV/AIDS activities shall have political support at all levels  PHAs shall be involved at all levels and in all matters of policy, management and services concerning HIV/AIDS  Individual rights, including their confidentiality shall be protected  There will be equal protection of the lives of PHAs as any other persons in Uganda 5

PRINCIPLES AND CORE VALUES (Cont’d)

 There will be no discrimination of PHAs on any grounds  There will be equal treatment under the laws of Uganda regardless of HIV status  There will be shared responsibility between the Government and the public to care for PHAs  Human rights approach shall be used to respond to the challenges of HIV/AIDS and PHAs.

 Orphans and widows shall be protected through legislation and through welfare services 6

PRINCIPLES AND CORE VALUES (Cont’d)

 There will be a multi- sectoral approach to the management of HIV/AIDS with the involvement of communities.

 HIV/AIDS management shall be an integral part of the national development.

 Equal opportunity shall be given to PHAs as the rest of Ugandans for health care, employment, education and any other socio-economic benefits.

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UGANDA’S NATIONAL POLICY IMPLEMENTATION GUIDELINES FOR HIV VCT FOR CHILDREN

 Legal age of consent in Uganda is 18 years. For VCT the policy prescribes the age of 12 years.

 Children 12 – 17 years should consent but with the approval of parents or guardians –controversial!!!

  For children below 12 yrs, the parent or guardian should sign the consent. Where no parent/guardian available, the head of the institution, hospital, clinic or any other person responsible The counselor should assess the child’s ability to cope with the results 8

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HIGHLIGHTS OF RETUM’S HISTORY

RETUM has been reaching youth in several districts in Uganda since 1999. It has registered over 23,000 youth change their behavior and influence others.

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HIV testing has been encouraged and accepted.

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The main Hospital In Uganda Mulago has been visited several times a year.

Youth friendly VCT services introduced in 2001 HIV Positive Clients screening for TB and treatment of both latent and active TB has been encouraged.

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SERVICES THAT NEED INTERVATION

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Testing for HIV and syphilis

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Syndromic management of other STDs

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TB Treatment and TB preventive therapy

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Support for on-going counseling and social support

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Family Planning services

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Continuous training and teaching

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CD4+/CD8 testing

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Youth Friendly Services

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Training of VCT providers in and outside Uganda

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INTRODUCTION OF THE YOUTH PROGRAM

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An exploratory research carried out in Kampala and Masaka, Uganda revealed that youth perceived barriers that prevent them from accessing VCT as:

– – –

Lack of helping counseling Lack of information on VCT process Lack of confidentiality

– –

Lack of referral services High costs of HIV test We are therefore planning to construct a Teenage Information & Health Center (TIHC), and introduce Youth Friendly intervention programmes

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PROJECT ACTIVITIES

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Strengthening VCT services in Kampala and upcountry.

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VCT outreach services at Youth Institutions

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Behavior change communication (BCC) campaign to increase awareness

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Strengthening formalized referral system

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Basic training in VCT counseling for health providers .

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Training in VCT counseling for youth.

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ACCOMPLISHMENTS

 Trained 32 service providers on Youth Friendly VCT counseling  Oriented 30 Youth volunteers on the youth VCT programme  Promoted positive living through Radio & Posters 14

Benefits of VCT for HIV+ Clients

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Referral for AIDS care and support

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Better management of opportunistic infections and other STDs

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Informed decisions about marriage, pregnancy and sexual relationships

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TB screening and preventive therapy

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Possible reduced length of breastfeeding and/or alternative feeding

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Anti retroviral drugs where affordable

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Benefits of VCT for HIV- Clients

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Encourages behavioral change

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Marriage decisions

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Pregnancy decisions

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Couple counseling

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Opportunity for STD detection and treatment

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Reduction of fear, anxiety and a sense of hopelessness and futility

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Increased sense of hope, empowerment and efficiency

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PROPORTION OF CLIENTS SERVED BY AGE GROUP - 2010 3% 29% 13-17yrs 18-24yrs 25+yrs 68%

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PROPORTION OF YOUTH BY MARITAL STATUS

100 90 80 70 60 50 40 30 20 10 0 90.6

7.5

2 77.6

14.8

7.7

Never married Married Div/Sep/Widowed 13-17yrs 18-24yrs

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40 35 30 25 20 15 10 5 0 HIV PREVALENCE BY AGE GROUPS among youth 1st time testers F:15-19yrs F:20-24yrs M:15-19yrs M:20-24yrs 92 93 94 95 96 97 Test Year 98 99 '00 '01 '02

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SERO POSITIVITY BY GENDER 1990- 2003 MALE FEMALE 40 35 30 25 20 15 10 5 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 9466, 20976, 40188, 69679, 62985, 56034, 42413, 40098, 53816, 58321, 58150, 67,648 113,488

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CHALLENGES/CONSTRAINTS

       Inadequate funds for expanding facilities/services Sustainability of youth clubs Few organizations offering Youth Friendly referral services Funding availability for the existing plans and network.

Poor road network that need strong vehicles.

Training materials for counselors.

Lack of counselors 21

CHALLENGES cont’d

 Older children being accompanied by their parents or guardians compromises confidentiality so they often do not open up  Competences in child and youth counseling are limited  Stigma and discrimination against young people living with HIV/AIDS 22

Thank you.

contact

[email protected]

+256 782 370307

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